What is Telehealth?
The US Department of Health and Human Services defines telehealth as “the use of electronic information and telecommunication technologies to provide care when you and your doctor are not in the same place at the same time.“
Telehealth encompasses long-distance clinical care, patient education, public health, and health administration. Sometimes, the terms “telehealth” and “telemedicine” are used interchangeably, but in reality, telemedicine has a narrower focus than telehealth. Telemedicine refers specifically to remote clinical services only.
To get medical care using telehealth services, all you need is a phone or a device that enables you to connect to the internet. Telehealth can be something as simple as talking with your doctor over the phone, or it may include the use of other technologies like chat messages, emails, and video conferencing. Some healthcare providers enable patients to use remote monitoring devices that send health data straight to a physician for analysis, such as ECG monitoring devices. This, too, falls under the umbrella of telehealth.
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What medical services can be performed via telehealth technology?
According to a recent PwC Health Research Institute survey, healthcare providers are most likely to offer telehealth or virtual visits for mental health, family medicine, OB/GYN, and pediatrics. A study published in Health Affairs revealed that specialists making the most use of telehealth services from January through June of 2020 were endocrinologists, gastroenterologists, neurologists and pain management physicians. Services such as medication management and online counseling are a perfect fit for telehealth as well. Here is a sampling of the type of medical services you can reasonably expect to be performed via telehealth, according to telehealth.hss.gov:
- Prescription management
- Consultation for skin conditions
- Consultation for recurring conditions such as migraines or urinary tract infections
- Consultation regarding lab tests or X-ray results
- Therapy and online counseling
- Urgent care issues such as colds, coughs, or stomach ailments
- Post-surgical follow-up
The CDC adds the following ways telehealth can be leveraged:
- Management of chronic, non-life-threatening medical conditions
- Coaching and support for patients managing ongoing medical issues
- Physical therapy, occupational therapy, and other modalities in a hybrid approach that utilized both virtual visits and in-person visits
- Case management for those in remote or rural areas
- Non-emergent care for residents in long-term care facilities
Healthcare providers can also send you information via technologies that enable telehealth. For example, your healthcare provider may email you specific instructions about how to continue your care at home, texts to remind you of an upcoming appointment, or educational materials to help you address a particular health challenge.
Interestingly, consumers and healthcare providers have varying views regarding which services are best handled by virtual visits, as highlighted in the PwC survey. When asked the question ‘For which services would you consider using video virtual care services instead of an in-person visit?’, consumers and healthcare providers were not totally in alignment, as noted below:
(Source: PwC Health Research Institute Survey)
In any case, it seems likely that telehealth utilization will continue to expand as more consumers try telehealth services and healthcare providers invest in the technologies that enable telehealth. According to experts, the global telehealth market was estimated to be $63.4 billion in 2020 and is expected to reach $167.2 billion by 2025, growing at a CAGR of 21.4%.
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What is driving the Telehealth trend?
There are multiple factors contributing to the rise in telehealth, but two stand out as most influential:
- The global pandemic
- The increasing consumerism of healthcare
How the Pandemic Impacted Telehealth Adoption
Prior to the global pandemic, use of telehealth services was growing steadily, but slowly, across multiple healthcare specialties. However, during the height of the pandemic, telehealth adoption grew by leaps and bounds.
According to Fierce Healthcare, for example, Summus Global, a virtual specialist care company, saw a 3x increase in the utilization of its platform from January 2020 to January 2021, and its membership increased by 1,095% in that same time period.
McKinsey research revealed that health systems, independent practices, behavioral health providers, and others reported 50-175x the number of telehealth visits pre-COVID.
The PwC survey mentioned earlier reveals the dramatic pandemic-driven rise in telehealth usage, as well as other non-traditional settings for medical treatment, with virtual visits showing a 97% growth rate.
Other studies of telehealth adoption rates and use by consumers tell a similar story. A study of over 36 million Americans published in JAMA revealed that telehealth use increased from 0.3% of contacts in 2019 to 23.6% of all contacts in 2020, a significant rise by any objective standard. During the March to April peak of new cases of COVID-19, telehealth usage went from less than 1% of visits to as much as 80% of visits in areas where the prevalence of COVID cases was highest.
A survey by SYKES revealed that most Americans have now experienced some form of telehealth.
Though the pandemic played a huge role in the spike of telehealth adoption rates, the reality is that telehealth is expected to continue to grow post-pandemic. eMarketer analysts projected in the latter part of 2020: “41.7 million adults in the US will use telemedicine, representing 98.8% growth from a year prior, according to our latest estimates. We expect this behavior to stick and for growth to continue through the end of our forecast period in 2023, when the number of users will be more than triple that of 2019. By the end of 2023, there will be 64.0 million telemedicine users.”
How Consumerism in Healthcare Impacts Telehealth Growth
Even prior to the pandemic, the trend of consumerism in healthcare was growing. (You can read more about it in our blog entitled “How Consumerism Has Changed the Face of Healthcare Forever.”)
Basically, consumerism in healthcare refers to the way that patients now make choices regarding the healthcare providers they will use and the services they will request from those providers. Just as consumers shop around for the best deal on retail items, patients are now comfortable with comparing costs and services from one provider to another and choosing the provider and services that most resonates with them.
As patients become ever more digitally savvy, they have come to expect that their healthcare providers will facilitate digital experiences for them, in much the same way they expect other service providers to do so. Patients are now looking for quality of care provided at minimum cost and maximum convenience.
Telehealth services meet those criteria quite well by providing:
- The convenience of ready access to a healthcare provider from home or anywhere you have an internet connection
- Cost savings inherent in telehealth (as many service providers charge less for telehealth visits and the cost of travel to and from a doctor’s office or medical facility has been eliminated)
- A high quality of care, as shown by a recent J D Powers survey, which revealed that telehealth had a score of 860 out of 1,000, which is among the highest scores ever recorded in the healthcare sector
Who is using telehealth today?
A wide variety of people use telehealth services today. (For more information about the demographics of telehealth in America, see our blog entitled “Telehealth Demographics for 2021: What We Know Now.”)
Here are just a few interesting statistics regarding who’s using telehealth today:
- 74% of Millennials prefer telemedicine over in-person office visits
- Just over 24% of those between the ages of 18 to 24 years use telehealth, compared to 11% and 5.4% of those between the ages of 45 to 64 and those over the age of 65, respectively
- Most telehealth encounters were for adults aged 18–49 years (66% in 2019 and 69% in 2020) and female patients (63% in both 2019 and 2020)
- 41% of Gen Z patients prefer digital or virtual experiences with medical professionals
- More than half (55%) of people making $50,000 to $100,000, 70% of those earning $100,000 to $200,000 and 70% of those with an income of more than $200,000 have access to telehealth
How do patients and healthcare providers feel about telehealth?
Generally speaking, those who have participated in telehealth visits are satisfied with their experience. The SYKES survey mentioned earlier revealed these insights regarding patient sentiment:
- 64.05% of respondents said they would prefer to have parts of their annual physical done via telehealth
- 74.25% of patients would be willing to share health data from a fitness tracker or smart medical device with their physician
- 85.52% of patients said that telemedicine has made it easier to get the care they need
- 51.64% of patients said that they have been able to see their doctor more often virtually
- 31.26% of patients reported that their medical costs have decreased since adopting telehealth
- 31.01% of patients said that their doctor seemed more empathetic in virtual visits
- 62.58% of patients who self-identified as being afraid to go to doctor visits said their fears were eased during their telehealth experience
- 74.2% of patients believe that telehealth appointments will become the norm for non-urgent medical consultations after COVID-19
- 87.82% of patients want to continue using telehealth after COVID-19, compared to 65.6% who felt doubtful about the quality of care provided via telehealth one year ago
- 79.85% of patients believe it is possible to get quality care through telehealth, compared to 56.40% who felt it was impossible just one year ago
- 77.2% of patients are willing to try telehealth in the future
- 41% of patients felt that one of the major benefits of telehealth was not having to travel to see their doctor
- 23.3% of patients cited not having to be around other patients in a waiting room as a top benefit of telehealth
Other studies reveal similar results:
- 82% of consumers believe that virtual care is an ideal way to monitor health
- 93% of clinicians feel that telemedicine is an acceptable mode of medical care
- 62.6% of patients find telehealth equally as effective as in-person visits
- 77% of clinicians feel that on-demand telehealth either is maintaining or improving patient outcomes
- 80% of Americans rated telehealth services as equal to or better than in-person healthcare
- 46% of Americans reported that, without telehealth, they would have to wait an average of two weeks longer to see a doctor in-person
- 56% of Americans reported that using telehealth services has improved their ability to navigate technology
- 54% sought out medical advice more often with telehealth options
- 56% felt that routine health check-ups are most effective via telehealth
- 76% of Americans said they plan to continue using telehealth tools in the future
In late 2020, the COVID-19 Healthcare Coalition Telehealth Impact Study Work Group surveyed a number of physicians across multiple specialties to see how offering telehealth has impacted their patients and practices. When asked to indicate agreement or disagreement with specific impact questions, here are some of the responses received:
What happens in a telehealth visit?
The answer to this question depends somewhat on the technology being used for the telehealth visit. For example, if your telehealth visit is being conducted via phone only, it is likely that your healthcare provider will give you a specific phone number and time to call.
When you make the call, someone on your provider’s care team will answer, and the visit will begin with some general health questions just as an in-person visit would begin. Once your care provider has gathered all the information needed, he or she will walk you through the next steps, which typically include explaining your diagnosis and treatment options. If any follow-up care is needed or if your provider feels that an in-person visit is required to properly handle your medical situation, you will be advised of how to proceed, and any follow-ups will be scheduled. If medications are needed, your provider will likely be able to electronically deliver your prescription to the pharmacy of your choice.
For video visits, the process is a bit different. Your provider will send you a link to the appointment via email or text. When you click the link at the appointment time, you may see a small set of instructions on your device, some of which may be designed to ensure that your audio and video is working correctly. Follow any onscreen instructions.
Once you have completed those instructions, you will either be directly connected with your care provider or directed to a virtual waiting room. When your provider is available, he or she will connect and you will then see and hear your provider during the visit.
Once the connection is made, your visit will proceed much like an in-person visit, with your provider asking questions and discussing your medical situation with you face-to-face (or screen-to screen, in this case). If any follow-up care is needed or if your provider feels that an in-person visit is required to properly handle your medical situation, you will be advised of how to proceed, and any follow-ups will be scheduled.
Generally, a video visit lasts about the same amount of time as an in-person visit would last. The advantage of the video visit, however, is that you can see your care provider without the time, expense, and effort involved in commuting to an actual office.
How can you prepare for a telehealth visit?
- When you make your appointment for a virtual visit, be sure to make a note of it in your calendar, just as you would do for an in-person visit.
- Use a camera that works well for a video visit. A good camera on your phone or other mobile device will help your healthcare provider to see you clearly and make the proper observations.
- Test your camera in advance. Try using your camera with a friend or family member to work out any technical difficulties before the day of your appointment.
- Test the sound and video on your device. Once again, it makes sense to try out your equipment with a friend or family member to ensure that you can see and hear properly while using your device. If sound is an issue, consider using ear buds or headphones during your virtual visit.
- Use the best internet connection possible. The better your connection, the less likely it is that you will lose your connection during the visit. However, if you should lose your connection, your provider will likely call you to continue the visit via phone instead.
- Charge the device you will be using for the visit to ensure it will last for the entire time of the visit.
- Find a quiet place with good lighting so that both you and your healthcare provider can see and hear well during the visit.
- Position yourself so that you are clearly visible on camera. If possible, position your device on a sturdy surface so you can move around during the visit if you need to do so.
- Prepare a list of questions or concerns to discuss with your healthcare provider, just as you would for an in-person visit. This is especially important for video visits since you may be a bit distracted because of the unfamiliar format of the visit.
- Be prepared to enter your payment information when required. Have your information handy so that you do not have to search for it during the call.
How do traditional health insurance policies handle the cost of telehealth?
One of the drivers behind the current growing acceptance of telehealth as a viable option is the cost factor. One study found that the average cost of a telehealth visit was $79, whereas the average cost of an in-person visit was $146. Adding in the savings in travel expenses or work time loss, the total savings becomes even more significant.
Prior to the pandemic, one of the barriers to telehealth adoption was the reluctance of health insurance providers to cover telehealth visits. Further, the governmental regulatory stance on both state and federal levels was that Medicare and Medicaid would pay for telehealth visits.
However, that changed considerably in the wake of COVID-19, as this KFF chart illustrates:
State laws also changed in response to the pandemic, with many states issuing emergency orders to remove certain regulatory requirements and allow telehealth visits. Many major private insurers also relaxed their policies, offering policyholders some amount of reimbursement for telehealth services.
The question looming in the minds of healthcare providers, however, is whether this general loosening of restrictions that has led to an increase in the use of telehealth during the pandemic will remain in effect after the pandemic.
Addressing this questions, the Medical Group Management Association observed in early 2021: “In January, Acting Secretary of Health and Human Services Norris Cochran stated that the (public health emergency) PHE will likely remain in place through 2021 and that the Administration will give states 60 days’ notice before it decides to terminate or let it expire. If true, medical groups should not encounter a “telehealth cliff” this year, in which PHE flexibilities suddenly disappear at the conclusion of the PHE.”
That said, the future of regulation in the telehealth space beyond the pandemic remains, to some extent, unclear.
How can you handle the cost of telehealth in a better way?
There is a better way to handle the cost of telehealth services: health sharing ministries. Some health sharing programs offer telehealth services free of charge to their members. For example, here are the telehealth policies of some of the most popular Christian health sharing ministries:
If you are looking for a way to save money on the costs of medical care, including telehealth services, health sharing ministries are an option you should consider. US Healthshare can help you find the health sharing program that suits your unique needs. Contact US Healthshare today to learn how to share the health.